Medical Director, Medical Affairs

Job not on LinkedIn

🔥 14 hours ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Provide clinical support and consultative activities across the PBM • Provide consultative clinical support to Account Management for assigned key clients • Review medication utilization requests and medical necessity appeals for commercial clients, Medicare/Medicaid programs, and individual client coverage determinations • Participate in peer-to-peer conversations when required • Support evening and weekend coverage across commercial, Medicare, and Medicaid segments as needed • Participate in inter-rater review activities and quality oversight processes for internal Director utilization-management decisions • Provide oversight of portions of CVS Health’s clinical programs and commercial client program support • Share in reviews of utilization management criteria and clinical policy revisions and reviews • Perform special clinical investigations and research requested by the Senior Medical Director • Review published literature on pharmaceutical questions and collaborate with pharmacists within Medical Affairs and other business units • Review clinical cases and coverage requests involving specialty medications, oncology therapies, biologics, and newly marketed drugs • Synthesize clinical information, evaluate medical evidence, and make objective, evidence-based coverage determinations

🎯 Requirements

• ABMS or AOA Board Certified in Internal medicine or Family Medicine • CURRENT FAMILY MEDICINE OR INTERNAL MEDICINE BOARD CERTIFICATION IS REQUIRED • Minimum of 5 years of clinical experience in direct patient care • 2 or more years proven experience in clinical outcomes • Solid understanding of medical statistics, regulatory agencies, and analytic programs • Unrestricted license to practice medicine in the state in which the candidate is located • Must be graduate of an accredited Medical School and Residency Program • Possess an unrestricted active license to practice medicine in a State, Territory, Commonwealth of the United States, or the District of Columbia • Required annual Continuing Medical Education (CME) up to date and must remain current in medical and management areas during employment • Proficiency in MS Office Suite • Additional subspecialty board certification is strongly preferred • Combination of five years of management and/or clinical experience in a managed care environment and health administration preferred • Master’s Degree in Public Health Administration or MBA preferred • UM/QA certification desired

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Award target in the company’s equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume